Navigation Links
Childhood Stroke More Common Than Thought
Date:9/17/2009

Study finds double the incidence reported previously

THURSDAY, Sept. 17 (HealthDay News) -- The incidence of stroke among American children could be two to four times greater than has commonly been estimated, a new study says.

Pediatric strokes are rare; even the new estimate puts its incidence at only 2.4 strokes per 100,000 person-years (person-years represent the number of years children were studied). But the report, published in the Sept. 17 online issue of Stroke, also cites five previous studies in which the estimated incidence ranged from .54 to 1.2 per 100,000 children per year.

"All those studies relied on billing coding to identify patients with stroke," explained study author Dr. Heather J. Fullerton, director of the Pediatric Stroke and Cerebrovascular Disease Center at the University of California, San Francisco, Children's Hospital. "Our study looked first at billing, and then at radiology reports."

Fullerton and her colleagues looked at data on 2.3 million children up to the age of 19 who were enrolled in the Kaiser Permanente managed-care plan in northern California from 1993 to 2003. They searched for stroke cases listed by diagnostic code for billing purposes and also for reports indicating strokes in radiological studies, including computed tomography and MRI. The radiology reports yielded a higher incidence of stroke.

Estimates based on billing are not reliable for several reasons, Fullerton said. "Children who have strokes often are ill for other reasons, such as meningitis or congenital heart disease, so they are coded for that," she said. "Also, coders apply the stroke diagnoses less often for children because they are perceived as rare events. Or they get nonspecific diagnoses."

The concept that children simply don't have strokes is widely prevalent, Fullerton noted. "Even among insurance companies, the impression seems to be that strokes don't happen to children," she said. "I have received calls from insurance companies questioning a diagnosis of stroke in a child."

Dr. E. Steve Roach, director of pediatric neurology at Nationwide Children's Hospital in Columbus, Ohio, who said, "I've been studying stroke in kids for 20 years," added that "the new study confirms what I've been saying all that time. It's just way, way underdiagnosed."

Roach said he led two studies, one reported a decade ago, the other last year, that came to the same conclusion. "When we did a search of discharge records, a lot of them just did not show up," he said.

"Most people, and even most doctors, can't accept the idea that children have strokes," Roach said. "It's just a bias on the part of physicians that stroke just doesn't occur in children."

This new comparison of the two methods of identifying a pediatric stroke found that radiological evidence was much more sensitive than the billing code. The radiology method was far more sensitive (83 percent) than the billing code method (39 percent.)

The difference was even greater for strokes that occurred at the time of childbirth, with a sensitivity of 12 percent using the billing codes and 87 percent using radiological records.

But the study came with a word of caution. Because it was based on data from one health-care organization, it's not clear whether the difference in incidence between billing codes and radiological findings will be found elsewhere, the report noted.

More studies in different populations are needed to firm up the finding, Fullerton said.

Failure to identify a childhood stroke properly might not be an issue for the child's family, Fullerton said. "It is more an issue for those of us who investigate strokes," she said. "When we try to identify pediatric strokes, it is important that we recognize that we could be missing a large chunk of cases."

More information

Learn about pediatric stroke from the American Stroke Association.



SOURCES: Heather J. Fullerton, M.D., director, Pediatric Stroke and Cerebrovascular Disease Center, University of California, San Francisco, Children's Hospital; E. Steve Roach, M.D., director, pediatric neurology, Nationwide Children's Hospital, Columbus, Ohio; Sept. 17, 2009, Stroke, online


'/>"/>
Copyright©2009 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Presentation at Annual Meeting Highlights Increased Risk of Heart Failure in Childhood Cancer Survivors
2. Treating Childhood Leukemia With Fewer Side Effects
3. Video: U.S. Department of Health and Human Services Joins Ad Council and Warner Bros. Pictures to Combat Childhood Overweight and Obesity
4. COSHAR Foundation Promotes Importance of Timely Childhood Immunization at Black Family Reunion Celebration in Washington, D.C.
5. Doctors Efforts to Fight Childhood Obesity Not Working
6. The American Heart Association Applauds Recommendations in New Childhood Obesity Report
7. ING Awards $100,000 in Grants to Combat Childhood Obesity
8. Aflac Announces Support for Childhood Cancer Awareness Month
9. U.S. Childhood Vaccine Rates Good But Could Be Better: CDC
10. St. Jude Childrens Research Hospital(R), Chilis(R) Grill & Bar Kick-off Sixth Annual Create-A-Pepper to Fight Childhood Cancer Campaign
11. Fragile period of childhood brain development could underlie epilepsy
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Childhood Stroke More Common Than Thought
(Date:10/12/2017)... , ... October 12, 2017 , ... The American College ... to Carol Friedman, PhD, FACMI, during the Opening Session of AMIA’s Annual Symposium in ... , In honor of Morris F. Collen, a pioneer in the field of medical ...
(Date:10/12/2017)... ... October 12, 2017 , ... Information about the ... to develop to enable prevention of a major side effect of chemotherapy in ... in pediatric patients. For cisplatin, hearing loss is FDA listed on-label as a ...
(Date:10/12/2017)... PA (PRWEB) , ... October 12, 2017 , ... ... is the recipient of a 2017 Folio Magazine Eddie Digital Award for ‘Best B-to-B ... York City on October 11, 2017. , The annual award competition recognizes editorial and ...
(Date:10/12/2017)... ... ... On Saturday, October 21, the Health & Wellness Center at Florida Hospital ... for the American Heart Association Heart Walk. Teams of up to 10 people can ... their treadmills moving for 5 hours. Treadmills will start at 7:00 p.m. on Saturday, ...
(Date:10/12/2017)... ... October 12, 2017 , ... Health Literacy Innovations (HLI), creator ... tool, and the Cancer Patient Education Network (CPEN), an independent professional organization that ... new strategic alliance. , As CPEN’s strategic partner, HLI will help support ...
Breaking Medicine News(10 mins):
(Date:10/4/2017)... Korea , Oct. 4, 2017  South Korean-based ... next-generation CPR training aide "cprCUBE" on Kickstarter. The device ... compression during cardiac arrests with better efficiency compared to ... also offers real-time feedback on efficacy of the compression ... crowdfunding campaign has a goal to raise $5,000. ...
(Date:10/4/2017)... Oct. 4, 2017 OBP Medical ... illuminating medical devices, today announced regulatory approval from ... Agency (or Agência Nacional de Vigilância Sanitária (ANVISA)) ... cordless surgical retractor with integrated LED light source ... illumination and exposure of a tissue pocket or ...
(Date:10/2/2017)... -- Eli Lilly and Company (NYSE: LLY ) ... of 2017 on Tuesday, October 24, 2017. Lilly will ... the investment community and media to further detail the ... begin at 9 a.m. Eastern time. Investors, media and ... the conference call through a link that will be ...
Breaking Medicine Technology: